The human microbiome is the aggregate of all the microbes residing in the human body. The microbiome types include protists, bacteria, viruses, fungi, etc. They coevolve with human beings and are vital to human life and health.
Microbiomes have a dynamic composition. Humans can access control over the content and architecture of their microbial communities. They play a distinctive role in influencing the host’s nutrition, immunity, development, and physiology. There is abundant evidence that suggests the importance of human microbiomes in human health and disease.
Human Microbiomes and Drug Development
Given the rising chronic disorders, there is growing adoption of human microbiomes for early disease detection, therapeutics, diagnosis, and subsequent drug development. The microbiome plays a substantial role in the efficiency of therapeutic compounds. It gives a major source of reductive metabolizing capability.
The microbiome-based drugs can be targeted to restore a healthy human microbiome’s complex ecology and function. Microbiomes associated with disease and heath facilitate effective therapies created to disrupt unhealthy microbial ecological networks by forming healthy ones.
Several companies are prioritizing the development of microbial drugs, which is estimated to drive the microbiome market growth with regard to therapeutics. Moreover, microbiome-driven drug metabolism is central to the initiation of certain prodrugs. For instance, azo drugs like prontosil and neo prontosil, leading to sulfanilamide release.
Microbiome’s essential role in the therapeutics of several mainstream diseases:
1. Cancer
Cancer is the second deadly disease globally and needs effective treatment. Microbiomes are extensively used for developing four significant drug categories. Immune system activators effectively warm up the immune system to kill the tumor cells. Immune-oncology drugs dependent on gut microbes for killing tumor cells are injected with inclusive add-ons to increase efficiency and reduce side effects. Probiotic mixture-based drugs cut the supply of nutrients necessary for the growth of tumor cells. Chemotherapy adjuncts are used to reduce the adverse effects of the therapy.
E.g., six microbiome-based medicines are in the process of development for various types of cancer, four of which namely, Micabodies by Avidbiotics, Symberix compounds by Symberix, Oncobiotics by Evelo Biosciences, and SER-155 by Seres Therapeutics are expected to be launched by 2021 in the US market.
2. Obesity:
Obesity is the result of the disruption of gut microbes. These microbiomes play a crucial role in regulating weight and producing additional energy and vitamins by breaking down the fiber. It assists the host in carrying out activities otherwise difficult to perform individually.
Microbiome-based medicine for controlling obesity and restoring gut microbes to a healthy state is of two significant types. The first one is small-molecule agents that help reduce the absorption of dietary fats and improve gastrointestinal functions. The second type is where the fecal microbes from healthy and lean individuals are extracted and transplanted into obese individuals to reduce obesity.
E.g., the microbiome-based drugs that are in the process of development to treat obesity are NM-504 and NM-313 by Microbiome Therapeutics and fecal microbiota transplant by Seres Therapeutics.
3. Skin disorders:
Human skin is a host for many microbiomes that help maintain pH levels, control skin density, and reduce skin inflammation. The most common skin disorders are acne, rosacea, and atopic dermatitis. Microbiome-based drugs for skin disorders are either in the form of additional beneficial bacteria or immuno-therapy (vaccines), developed specifically to target the harmful bacteria and manage skin disorders.
E.g., B-244 is being developed by AOBiome to treat skin disorders.
4. Lactose Intolerance:
Lactose intolerant people have a low level of lactase, the bacteria responsible for breaking down lactose. It is a gastrointestinal condition where consuming lactose-based products (mostly dairy products) can cause adverse reactions like excessive production of gas, etc. Drug development strategies for this disease include the development of a product that intensifies lactase-producing bacteria and improves colon function.
E.g., RP-G28 by Ritter pharmaceuticals is a microbiome-based drug undergoing clinical trial for lactose intolerance.
A Promising Future
Chronic diseases like cancer and cardiovascular diseases are on the rise worldwide. WHO estimates that 23.3 million people by 2030 will be fatally affected by CHD, CVC, and other heart diseases. Also, according to the American Cancer Society, in 2017, around 95,520 had colorectal cancer. In addition, as per the International Diabetes Federation estimates, the global diabetes prevalence is expected to reach 642 million by 2040.
Such aspects offer lucrative prospects to the global human microbiome market. Mainly because they affect host physiology to a great extent. Also, their interaction with the immune system impacts several human metabolic functions and the evaluation of the disease status of the human body.
Furthermore, the human microbiome is projected to enable a new era of personalized medicine, wherein customized treatment would be given per each individual’s reaction to treatments. Besides, the future human microbiome-based drug discovery will also consider dietary elements, environmental factors, and genetic makeup, alongside the complete microbiome composition.